We tested whether transplant arteriosclerosis can be reduced by pre-treatment of the donor with immunosuppressive agents, using a rat allogeneic aorta transplantation model. Donor rats received no pre-treatment, or tacrolimus, methylprednisolone, rapamycin, or mycofenolate mofetil (MMF) 16 and 2 h before explantation of the grafts. Eight weeks after transplantation, aorta allografts were harvested. Percent intima area/intima + media area (I/I + M), inflammatory cells and in situ MMP-2 and -9 activity were determined. In pre-transplantation biopsies, MMP-2 and -9 ratio, and mRNA levels for genes of interest were determined. In pre-transplantation biopsies we found no differences in MMP-2/9 ratio, and Bcl-2, Bax, TGF-β, HO-1, p21, and HIF-1α mRNA expression between the groups. Aorta allografts, pre-treated with tacrolimus, showed significantly lower I/I + M ratio compared to untreated controls (p < 0.01). Pre-treatment with methylprednisolone, rapamycin or MMF did not significantly reduce I/I + M ratio. In situ MMP-2/MMP-9 activity was significantly reduced in grafts treated with tacrolimus and rapamycin compared to controls (p < 0.05). Immunohistochemistry revealed a high number of CD4+ cells and high CD4/CD8 ratio in grafts pre-treated with tacrolimus. Donor pre-treatment with tacrolimus significantly reduces transplant arteriosclerosis and is associated with reduced in situ MMP-2/MMP-9 activity and increased number of CD4+ cells.

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doi.org/10.1016/j.phrs.2008.12.006, hdl.handle.net/1765/24494
Pharmacological Research
Erasmus MC: University Medical Center Rotterdam

Susa, D., van den Engel, S., van Damme, L., Roest, H., Krams, R., IJzermans, J., & de Bruin, R. (2009). Donor pre-treatment with tacrolimus reduces transplant vasculopathy. Pharmacological Research, 59(4), 273–278. doi:10.1016/j.phrs.2008.12.006